Operationalising Genomic Surveillance for Antimicrobial Resistance in Low- and Middle-Income Countries: A One Health Perspective from Bangladesh
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
The extensive review presented by Singh and Mitra addresses the issue of AMR in low- and middle-income countries, providing an in-depth description of the main factors contributing to its occurrence, the actions already taken by some countries and their main outcomes, and outlining future perspectives for controlling this problem.
Given the relevance of the topic addressed, the work has scientific merit but requires adjustments.
Remarks
In the title, the authors should specify “low- and middle-income countries.”
L23–24: As reservoirs of resistant bacteria. It is the bacteria that are resistant, not the hosts.
Throughout the manuscript, standardize the use of the term antimicrobial resistance and avoid using only resistance.
The abstract needs to be formatted as a single paragraph.
The references need to be converted to a numerical format throughout the manuscript, including in the tables.
L44: Add reference to this information.
L56–57: Correct the sentence formatting.
L103–105: Add reference.
L130: Remove the superscript “1”.
L184: Check the use of italics for all scientific names throughout the manuscript. Double-check them.
L189: I did not understand the term ESBL-to-general E. coli.
Section 1.5 addresses only poultry without including data on swine.
L195: Add reference.
I believe it is also important for the authors to mention data on antimicrobial use in cattle.
L248: Add reference.
L335: Review the MDPI reference, as it is a publisher.
Section 3.3 could be subdivided into 3.3.1 and 3.3.2, one for each country.
L371 and elsewhere: The genus name should be written in full only at its first mention in the manuscript (Klebsiella pneumoniae). From the second mention onward, use the abbreviated genus (K. pneumoniae). Review this throughout the manuscript for all microorganisms.
L387: Typhi should be written without italics, as it refers to a serotype.
L389: Add reference.
In Tables 4 and 5, the nomenclature of several genes needs to be revised to comply with international scientific standards, including the use of subscripts for several of them (such as bla genes).
In Table 5, there is a column titled key resistance genes, but in some rows the entries are not genes. The column title needs to be revised.
The Data Availability Statement needs to be updated, as it currently contains the journal template.
Author Response
We have added all the points addressed by Reviewer-1
We thank the reviewers for their constructive feedback. We have addressed each comment in detail, as outlined below.
Remarks from Reviewer-1
The extensive review presented by Singh and Mitra addresses the issue of AMR in low-and middle-income countries, providing an in-depth description of the main factors contributing to its occurrence, the actions already taken by some countries and their main outcomes, and outlining future perspectives for controlling this problem. Given the relevance of the topic addressed, the work has scientific merit but requires adjustments.
- In the title, the authors should specify “low- and middle-income countries.”
As per revierwer’s suggestion changed title to “Operationalising Genomic Surveillance for Antimicrobial Resistance in Low-and Middle-Income Countries: A One Health Perspective from Bangladesh” (L3)
- L23–24: As reservoirs of resistant bacteria. It is the bacteria that are resistant, not the hosts.
Throughout the manuscript, standardize the use of the term antimicrobial resistance and avoid using only resistance.
Standardized terminology across the manuscript to use “antimicrobial resistance (AMR)” and clarified “resistance” as “antibiotic resistance” where appropriate for precision. (Edits made throughout the paper)
- The abstract needs to be formatted as a single paragraph.
Reformatted the abstract into a single paragraph (L11–26).
- The references need to be converted to a numerical format throughout the manuscript, including in the tables.
Response: Converted all references to numerical format throughout the manuscript and tables, following MDPI guidelines.
- L44: Add reference to this information.
L38-39: Reference added to the line “Low- and Middle-Income Countries (LMICs) experience the most severe health and economic consequences of AMR, a reality shaped by a convergence of systemic vulnerabilities, with antibiotic resistance rates three to four times higher than in high-income countries (HICs)”
- L56–57: Correct the sentence formatting.
Corrected sentence formatting and readability (L87–88).
- L103–105: Add reference.
Added an appropriate supporting reference (L130–132).
- L130: Remove the superscript “1”
Removed the superscript and standardized the referencing format across the manuscript (L159).
- L184: Check the use of italics for all scientific names throughout the manuscript. Double-check them.
Scientific names italicised throughout the manuscript. (e.g., L 232, 234 etc).
- L189: I did not understand the term ESBL-to-general E. coli.
Rephrased the sentence for clarity and added a supporting reference (L240–242).
- Section 1.5 addresses only poultry without including data on swine.
Expanded the section to include swine data and revised the structure (content expanded in L235–238; section updated from 1.5 to 1.6).
- L195: Add reference.
Added the requested reference (L245–247).
- I believe it is also important for the authors to mention data on antimicrobial use in cattle.
Expanded the livestock AMR/AMU discussion to include cattle and added supporting data and references (L201–208).
- L248: Add reference.
Added a supporting reference (L295).
- L335: Review the MDPI reference, as it is a publisher.
Replaced/corrected the citation to reference the original source/article rather than citing the publisher entry (L383)
- Section 3.3 could be subdivided into 3.3.1 and 3.3.2, one for each country.
Re-structured Section 3.3 into subsections 3.3.1 and 3.3.2 to separate the two country case studies (L411 & 422).
- L371 and elsewhere: The genus name should be written in full only at its first mention in the manuscript (Klebsiella pneumoniae). From the second mention onward, use the abbreviated genus ( pneumoniae). Review this throughout the manuscript for all microorganisms.
Standardised microorganism naming so genus names are written in full at first mention and abbreviated thereafter (e.g., Klebsiella pneumoniae → K. pneumoniae L87) across the manuscript.
- L387: Typhi should be written without italics, as it refers to a serotype.
Corrected formatting so “Typhi” is not italicised where it refers to the serotype (L436).
- L389: Add reference.
Added supporting references (L435–443).
- In Tables 4 and 5, the nomenclature of several genes needs to be revised to comply with international scientific standards, including the use of subscripts for several of them (such as bla genes).
Revised gene nomenclature in Tables 4 and 5 to align with standard conventions, including formatting for bla genes (L484, L507).
- In Table 5, there is a column titled key resistance genes, but in some rows the entries are not genes. The column title needs to be revised.
Renamed the column to accurately reflect its contents and corrected entries to distinguish genes from other resistance determinants (L507).
- The Data Availability Statement needs to be updated, as it currently contains the journal template.
Updated the Data Availability Statement to remove template text and reflect the actual data access details (L673-675).
Reviewer 2 Report
Comments and Suggestions for Authors
The widespread use of antibiotics in medicine and agriculture has led to the spread of microorganisms resistant to antibiotics and other antibacterial drugs, which has now acquired alarming proportions. The World Health Organization declares the problem of microbial resistance to antimicrobials as one of the key threats to global stability and sustainable development of society. Therefore, currently, in most countries, close attention is being paid to the problems of antibiotic resistance. For the most part, we read reviews on national strategies to combat AMR in European countries. In this context, a review focusing on Asia, namely Bangladesh, is very interesting and useful. I think the review is written in good language and contains a lot of new information.
I just have a few comments:
I missed the Introduction section and Information about the methodology for searching and selecting articles for review.
There are not enough links everywhere. For example, sections 1.5. and 1.6 contain only one link at the end of the section. Whereas in section 1.6. the link suggests itself after the first sentence.
Author Response
We have added all the points addressed by Reviewer-2
We thank the reviewers for their constructive feedback. We have addressed each comment in detail, as outlined below.
Remarks from Reviewer-2
I missed the Introduction section and Information about the methodology for searching and selecting articles for review.
L47-77: Added Section 1.1 titled “Literature search strategy and selection criteria”.
There are not enough links everywhere. For example, sections 1.5. and 1.6 contain only one link at the end of the section. Whereas in section 1.6. the link suggests itself after the first sentence.
L191-242: Added references
